Signature Cross-Insurance Cost Matrix • NDC 27505011030Reversible MAO-B Inhibitor

Safinamide (Xadago): Cost Across Insurances

Complete cell-by-cell comparison across Self-Pay Cash, Original Medicare, 6 Major California Commercial Payers (Anthem, Blue Shield, UnitedHealthcare, Aetna, Cigna, Kaiser Permanente), and Medi-Cal — with every cell labeled with its official data source and effective date.

1. Published Prices(Cash & Medicare)2. Plan-Adjusted(Payer MRF Rate)3. Verified Price(Real-Time 270/271 Check)

Accuracy Level — Tier 1 Published Prices: You are currently viewing general published hospital cash prices, Medicare baselines, and multi-payer ranges. Add your insurance card to unlock Tier 2 plan pricing and Tier 3 verified benefit checks.

Tier 1: General Published Rates Across 9 InsurancesEvery cell labeled with official Source + Date • “Not published” shown honestly where proprietary

Hospital procedure cells are extracted from 14 Bay Area hospital MRFs (45 CFR § 180.50, Oct 2026); medication cells use CMS NADAC (as of 2026-10-28) & CY 2026 Medicare Part D / Medi-Cal Rx rules.

Parkinson's Service / Medication
Self-Pay / Cash Price
Hospital MRF / Retail Cash
Medicare Rate
2026 CMS / NADAC / Part D
Anthem Blue Cross
MRF Negotiated / Formulary
Blue Shield of CA
MRF Negotiated / Formulary
UnitedHealthcare
MRF Negotiated / Formulary
Aetna
MRF Negotiated / Formulary
Cigna
MRF Negotiated / Formulary
Kaiser Permanente
MRF Negotiated / Formulary
Medi-Cal (CA Medicaid)
CA DHCS / Medi-Cal Rx
MedicationNDC 27505011030
Safinamide (Xadago)
$1,120 – $1,290 / 30 days (30 tablets)

$1,120 – $1,290 / 30 days (30 tablets)

Source: CMS NADAC 2026 & Retail Pharmacy Cash Benchmarks (Oct 2026)
Date: Oct 2026
NADAC: $1,089.77 – $1,093.77 / 30 tablets (30-day supply)

XADAGO 50 MG TABLET ($36.45907/EA) & XADAGO 100 MG TABLET ($36.32581/EA) • Medicare Part D patient cost: 25%–50% coinsurance until hitting the $2,100 annual Part D out-of-pocket cap ($0 thereafter)

Source: CMS NADAC 2026 (data.medicaid.gov Dataset fbb83258-11c7-47f5-8b18-5f8e79f7e704) & CMS CY 2026 Medicare Part D Public Formulary File (Oct 2026)
Date: 2026-10-28
Not published

Tier 4 Non-Preferred Brand; Prior Authorization + Step Therapy (rasagiline/selegiline) required. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.

Source: Anthem Blue Cross 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021)
Date: Oct 2026
Not published

Tier 4 / Specialty; Prior Authorization + Step Therapy required. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.

Source: Blue Shield of CA 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021)
Date: Oct 2026
Not published

Excluded or Tier 4 with Prior Authorization + Step Therapy. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.

Source: UnitedHealthcare 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021)
Date: Oct 2026
Not published

Non-Preferred Brand; Prior Authorization + Step Therapy required. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.

Source: Aetna 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021)
Date: Oct 2026
Not published

Tier 4; Prior Authorization + Step Therapy required. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.

Source: Cigna 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021)
Date: Oct 2026
Not published

Non-Formulary (requires formulary exception after generic selegiline and rasagiline). Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.

Source: Kaiser Permanente 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021)
Date: Oct 2026
$0 patient copay

$0 copay ONLY with approved Medi-Cal Rx Prior Authorization documenting failure/intolerance of generic selegiline and rasagiline.

Source: CA DHCS Medi-Cal Rx Contract Drug List (CDL) & PA Policy
Date: Oct 2026
Audit-Grade Cell Verification (9/9 Insurance Columns Sourced)

Every Insurance Cell for Safinamide — With Source & Date Citations

Tier 1 Cash Baseline Published Rate

Self-Pay / Discounted Cash Price

$1,120 – $1,290 / 30 days (30 tablets)

$1,120 – $1,290 / 30 days (30 tablets)

Official Source: CMS NADAC 2026 & Retail Pharmacy Cash Benchmarks (Oct 2026)
Effective / Verified Date: Oct 2026
Federal Benchmark Published Rate

Original Medicare (CMS 2026 / NADAC / Part D)

NADAC: $1,089.77 – $1,093.77 / 30 tablets (30-day supply)

XADAGO 50 MG TABLET ($36.45907/EA) & XADAGO 100 MG TABLET ($36.32581/EA) • Medicare Part D patient cost: 25%–50% coinsurance until hitting the $2,100 annual Part D out-of-pocket cap ($0 thereafter)

Official Source: CMS NADAC 2026 (data.medicaid.gov Dataset fbb83258-11c7-47f5-8b18-5f8e79f7e704) & CMS CY 2026 Medicare Part D Public Formulary File (Oct 2026)
Effective / Verified Date: 2026-10-28
Commercial & MA MRF Not Published

Anthem Blue Cross (California)

Not published (PBM negotiated rate)

Tier 4 Non-Preferred Brand; Prior Authorization + Step Therapy (rasagiline/selegiline) required. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.

Official Source: Anthem Blue Cross 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021)
Effective / Verified Date: Oct 2026
Commercial & MA MRF Not Published

Blue Shield of California

Not published (PBM negotiated rate)

Tier 4 / Specialty; Prior Authorization + Step Therapy required. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.

Official Source: Blue Shield of CA 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021)
Effective / Verified Date: Oct 2026
Commercial & MA MRF Not Published

UnitedHealthcare (UHC)

Not published (PBM negotiated rate)

Excluded or Tier 4 with Prior Authorization + Step Therapy. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.

Official Source: UnitedHealthcare 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021)
Effective / Verified Date: Oct 2026
Commercial & MA MRF Not Published

Aetna

Not published (PBM negotiated rate)

Non-Preferred Brand; Prior Authorization + Step Therapy required. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.

Official Source: Aetna 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021)
Effective / Verified Date: Oct 2026
Commercial MRF Not Published

Cigna

Not published (PBM negotiated rate)

Tier 4; Prior Authorization + Step Therapy required. Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.

Official Source: Cigna 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021)
Effective / Verified Date: Oct 2026
Integrated HMO / MRF Not Published

Kaiser Permanente (Northern CA)

Not published (PBM negotiated rate)

Non-Formulary (requires formulary exception after generic selegiline and rasagiline). Commercial insurer-PBM net negotiated drug price is proprietary; CA SB 1021 caps state-regulated commercial copay at ≤ $250/30d if PA is approved.

Official Source: Kaiser Permanente 2026 CA Commercial Formulary & CA Health & Safety Code § 1367.241 (SB 1021)
Effective / Verified Date: Oct 2026
$0 Safety-Net Published Rate

Medi-Cal (California Medicaid / Medi-Cal Rx)

$0 patient copay

$0 copay ONLY with approved Medi-Cal Rx Prior Authorization documenting failure/intolerance of generic selegiline and rasagiline.

Official Source: CA DHCS Medi-Cal Rx Contract Drug List (CDL) & PA Policy
Effective / Verified Date: Oct 2026
CMS NADAC & Medicare Part D Formulary Details

Safinamide (Xadago) — Clinical & Formulary Summary

Open Full Medication Page

What it's for: Once-daily reversible MAO-B inhibitor approved as adjunctive treatment to levodopa/carbidopa in patients experiencing 'OFF' episodes. (Source: FDA Prescribing Information (NDA 207145) & Michael J. Fox Foundation)

CMS NADAC Baseline (2026-10-28)
XADAGO 50 MG TABLET ($36.45907/EA) & XADAGO 100 MG TABLET ($36.32581/EA)
30-Day Baseline: $1,089.77 – $1,093.77 / 30 tablets (30-day supply)
Source: CMS NADAC 2026 (data.medicaid.gov Dataset fbb83258-11c7-47f5-8b18-5f8e79f7e704)
2026 Medicare Part D Formulary Status
Tier: Tier 4 (Non-Preferred Brand) or Tier 5 (Specialty)
Prior Auth: Yes — requires documented 'OFF' episodes on carbidopa/levodopa AND trial/failure of generic rasagiline or selegiline
2026 Patient Cost: 25%–50% coinsurance until hitting the $2,100 annual Part D out-of-pocket cap ($0 thereafter)